<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group hide">
        <label class="control-label col-xs-12 col-sm-2">{:__('Presentation_drug_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-presentation_drug_id" data-rule="required" data-source="presentationdrug/index" class="form-control selectpage form-control" name="row[presentation_drug_id]" type="text"  value="{:$_GET['cid']}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Substance_specified_substance_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-substance_specified_substance_name" class="form-control form-control" name="row[substance_specified_substance_name]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Substancespecified_substance_termid_version_date_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-substancespecified_substance_termid_version_date_number" class="form-control form-control" name="row[substancespecified_substance_termid_version_date_number]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Substancespecified_substance_termid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-substancespecified_substance_termid" class="form-control form-control" name="row[substancespecified_substance_termid]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Strength_number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-strength_number" class="form-control form-control" name="row[strength_number]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Strength_unit')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-strength_unit" class="form-control form-control" name="row[strength_unit]" type="text">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
